Share on Facebook Share on Twitter Share on LinkedIn Share on Google+ Share by Email

Skip to content

Key resources

  • Bibliography
    Bibliography
  • Health promotion
    Health promotion
  • Health practice
    Health practice
  • Programs
    Programs
  • Conferences
    Conferences
  • Courses
    Courses
  • Funding
    Funding
  • Jobs
    Jobs
  • Organisations
    Organisations
  • Health Services MapHealth Services Map
Australian Indigenous HealthBulletin Alcohol and other drugs knowledge centre Yarning Places
 

Mortality

Mortality

There were 3,088 deaths in Australia in 2015 where the deceased person was identified as Aboriginal and/or Torres Strait Islander [1]. (Details for jurisdictions are provided in Table 5.)

Table 5. Numbers and proportions (%) of Aboriginal and Torres Strait Islander deaths, Australia, 2015

Jurisdiction

Number of deaths

Proportion of deaths %

NSW

822

1.5

Vic

141

0.4

Qld

842

2.8

WA

511

3.5

SA

167

1.2

Tas

50

1.1

NT

537

45.9

ACT

17

0.9

Australia

3,088

1.9

Source: ABS, 2016 [1]

Box 2: Data quality

The ABS Death Registration collection collects information on Indigenous status from the ‘death registration form’; some states and territories also collect this information from the medical certificate [1]. While the ABS deems it likely that most deaths of Aboriginal and Torres Strait Islander people are registered, the Indigenous status of some deaths is not registered, which raises concerns about the accuracy of this data [1][2]. Aboriginal and Torres Strait Islander deaths may be underestimated because of:

  • inaccurate data
  • lag in registration (the interval between when a death occurs and when it is registered).

This lag in registration is often longer for the Aboriginal and Torres Strait Islander population than the non-Indigenous population [2]. However, there is normally only a slight difference between registered and occurring deaths because, for each year, the number of deaths not registered balance out the deaths that occurred in the previous year but were registered late.

In 2015, there were 401 deaths for which no Indigenous status was reported, representing 0.3% of registered deaths; it is very likely that some of these deaths were among Aboriginal and Torres Strait Islander people [1]. The number of deaths with no Indigenous status reported has decreased over time [2].

Age-standardised death rates

During 2013-2015, age-standardised death rates for Aboriginal and Torres Strait Islander people were calculated only for NSW, Qld, WA, SA and the NT as they were the jurisdictions with adequate data quality [1]. During this period, the age-standardised death rate for Aboriginal and Torres Strait Islander people was 9.8 per 1,000 population, a small decrease from 10 per 1,000 in 2003-2005. Between 2003-2005 and 2013-2015, age-standardised death rates decreased for Aboriginal and Torres Strait Islander males (from 12 per 1,000 to 11 per 1,000) and increased for females (from 8.6 per 1,000 to 8.9 per 1,000).

Overall, the age-standardised death rate for Aboriginal and Torres Strait Islander people (9.8 per 1,000) was 1.7 times the rate for non-Indigenous people (5.4 per 1,000) in 2015 (Table 6) [1]. Rates for Aboriginal and Torres Strait Islander people varied by jurisdiction, with the highest rate occurring in the NT (15 per 1,000) and the lowest in NSW (8.0 per 1,000).

Table 6. Age-standardised death rates, by Indigenous status, and Indigenous:non-Indigenous rate ratios, NSW, Qld, WA, SA and the NT, 2015

Jurisdiction

Indigenous rate

Non-Indigenous rate

Rate ratio

NSW

8.0

5.8

1.4

Qld

9.6

5.6

1.7

WA

12

5.3

2.2

SA

8.6

6.0

1.4

NT

15

5.9

2.6

All jurisdictions

9.8

5.7

1.7

Notes:

  1. Rates are per 1,000
  2. Rate ratio is the Indigenous rate divided by the non-Indigenous rate
  3. Due to the incomplete identification of Indigenous status, these figures probably underestimate the true difference between Indigenous and non-Indigenous rates
  4. Rates are based on three year averages; for Aboriginal and Torres Strait Islander data, rates are calculated for each calendar year and then averaged to reduce variability in annual rates

Source: AIHW, 2016 [1]

Between 1998 and 2013, there was a 16% reduction in the age-standardised death rates for Aboriginal and Torres Strait Islander people in NSW, Qld, WA, SA and the NT; there was also a significant closing of the gap in death rates between Aboriginal and Torres Strait Islander and non-Indigenous people during this time period [3].

Box 3: Adjusting for age-structures of populations

Comparison of Aboriginal and Torres Strait Islander and non-Indigenous mortality needs to take account of differences in the age structures of the Aboriginal and Torres Strait Islander and non-Indigenous populations using a process known as standardisation. The process is also referred to as age-adjustment or age-standardisation.

Direct standardisation, the preferred method, applies detailed information about Aboriginal and Torres Strait Islander deaths, including sex and age, to a ‘standard’ population [4]. In Australia, the 2001 Australian estimated resident population (ERP) is generally used as the standard population. Direct standardisation enables accurate comparisons of Indigenous and non-Indigenous rates, and time-series analyses.

If detailed information is not available, it is still possible to use indirect standardisation to estimate standardised mortality ratios (SMRs). The SMR is the ratio of the numbers of deaths (or of other health measures) registered/observed to the number expected. SMRs allow for the comparison of numbers of registered Indigenous deaths with the numbers expected from the corresponding age-sex-specific death rates for the total population or, preferably, the non-Indigenous population.

Expectation of life

In 2013, the ABS published revised estimates for expectation of life at birth for Indigenous people [2]. After adjustment for the underestimate of the number of deaths identified as Indigenous, the ABS estimated that Aboriginal and Torres Strait Islander males born in Australia in 2010-2012 could expect to live to 69.1 years, 10.6 years less than the 79.7 years expected for non-Indigenous males. The expectation of life at birth of 73.7 years for Aboriginal and Torres Strait Islander females born in Australia in 2010-2012 was 9.5 years less than the expectation of 83.1 years for non-Indigenous females.

Revised estimates were also published for Indigenous people living in NSW, Qld, WA and the NT (Table 7).

Table 7. Expectation of life at birth in years, by Indigenous status and sex, selected jurisdictions, Australia, 2010-2012

Jurisdiction

Indigenous status/sex

 

Indigenous

Non-Indigenous

Difference

Males

NSW

70.5

79.8

9.3

Qld

68.7

79.4

10.8

WA

65.0

80.1

15.1

NT

63.4

77.8

14.4

Australia (unadjusted)

67.4

79.8

12.4

Australia (headline)

69.1

79.7

10.6

Females

NSW

74.6

83.1

8.5

Qld

74.4

83.0

8.6

WA

70.2

83.7

13.5

NT

68.7

83.1

14.4

Australia (unadjusted)

72.3

83.2

10.9

Australia (headline)

73.7

83.1

9.5

Notes:

  1. This table includes two estimates for Australia, The ‘headline’ estimate includes adjustments based on Australia-wide census-related information. These estimates should be used in all situations except those requiring comparisons with the estimates for the states and territories, for which Australia-wide census-related information could not be applied. The unadjusted Australian estimate should be used in situations requiring such a comparison.
  2. Australian estimates are based on deaths in all states and territories
  3. Differences are based on unrounded estimates

Source: ABS, 2013 [2]

Box 4: Data quality

Based on a linkage study of Indigenous identification in deaths registration and the 2011 Census, the ABS revised its estimates of life expectancy of Indigenous people [2]. The levels of under-identification, which differed by age-group, jurisdiction and remoteness of residence, were taken into account for the new estimates of Indigenous life expectancy. The ABS noted that correction of the underestimates of death numbers and rates would need similar adjustments. These findings confirm the caution that the ABS notes should be exercised in the interpretation of the estimates of Indigenous mortality, particularly estimates of trends over time. This caution is reflected in recent ABS publications that do not include detailed tables of Indigenous deaths, nor information about overall death rates. As a result, there is no consistency about the extent of information available for recent years. Reflecting this, readers should be aware that the following sections vary in terms of the years to which they relate.

Age at death

During 2013-2015, the median age at death9 for Aboriginal and Torres Strait Islander people in NSW, Qld, WA, SA and the NT was 57.9 years [1]. This marked an increase from 53.8 years in 2003-2005. The median age at death for Aboriginal and Torres Strait Islander males, 54.9 years in 2013-2015, increased from 50.9 years in 2003-2005; there was also an increase for females to 61.5 years from 58.4 years for the same period. The non-Indigenous median age at death was substantially higher at 81.9 years in 2013-2015.

The median age at death for Aboriginal and Torres Strait Islander males ranged from 51.5 years in WA to 58.0 years in NSW in 2015 (Table 8) [1]. For Aboriginal and Torres Strait Islander females, it ranged from 58.1 years in the NT to 65.2 years for those living in NSW. While the levels varied by jurisdiction for non-Indigenous males and females, the median ages were consistently higher for them than for Aboriginal and Torres Strait Islander people.

Table 8. Median age at death, by Indigenous status and sex, NSW, Qld, WA, SA and the NT, 2015

Jurisdiction

Indigenous

Non-Indigenous

Males

Females

Males

Females

NSW

58.0

65.2

79.1

85.2

Qld

55.7

62.6

77.6

84.2

WA

51.5

58.8

78.0

84.4

SA

53.4

60.1

80.1

85.7

NT

53.0

58.1

68.8

71.1

All jurisdictions

54.9

61.5

78.6

84.9

Notes:

  1. Information is not available for the other jurisdictions because of the relatively small numbers of deaths
  2. Median age of death is the age below which 50% of deaths occur

Source: ABS, 2016 [1]

In 2013-2015, in NSW, Qld, WA, SA, and the NT, age-specific death rates were higher for Aboriginal and Torres Strait Islander people than for non-Indigenous people across all age-groups [1]. The rate ratios were highest in the young and middle-adult years. Age-specific death rates have decreased since 2003-2005 in most age-groups for Aboriginal and Torres Strait Islander people.

In 2013-2015, the Aboriginal and Torres Strait Islander age-specific death rates was double the non-Indigenous rate in the 25-64 years age-group in NSW, and the 5-14 years and 25-74 years age-groups in Qld. In WA, SA, and the NT, age-standardised death rates were up to four times higher for Aboriginal and Torres Strait Islander people than those for their non-Indigenous counterparts in some age-groups.

Infant mortality

The infant mortality rate (IMR) is the number of deaths of children aged less than one year in a calendar year per 1,000 live births in the same calendar year. In NSW, Qld, WA, SA and the NT in 2013-2015, the Aboriginal and Torres Strait Islander IMR (6.5 per 1,000) was almost twice as high as the non-Indigenous IMR [1]. The IMR for Aboriginal and Torres Strait Islander infants in the NT decreased from 16 per 1,000 in 2003-2005 to 13 per 1,000 in 2013-2015.

Table 9. Infant mortality rates, by Indigenous status and sex, and Indigenous:non-Indigenous rate ratios, NSW, Qld, WA, SA and the NT, 2015

Jurisdiction

Indigenous

Non-Indigenous

Rate ratio

Males

Females

Males

Females

Males

Females

NSW

5.6

3.8

3.6

3.2

1.6

1.2

Qld

7.5

6.9

4.1

4.0

1.8

1.7

WA

6.3

4.8

2.1

1.9

3.0

2.5

SA

6.1

5.0

3.3

2.2

1.8

2.3

NT

14

12

2.0

4.1

7.0

2.9

All jurisdictions

7.1

5.8

3.5

3.1

2.0

1.9

Notes:

  1. Infant mortality rate is the number of infant deaths per 1,000 live births
  2. Rates are based on three year averages; for Aboriginal and Torres Strait Islander data, rates are calculated for each calendar year and then averaged to reduce variability in annual rates
  3. Rate ratio is the Indigenous rate divided by the non-Indigenous rate
  4. The Indigenous rates are likely to be underestimated, due to the incomplete identification of Indigenous status on births and deaths records
  5. Due to the small number of deaths registered in Vic, Tas and the ACT, these jurisdictions have been excluded

Source: ABS, 2016 [1]

In the five-year period 2010-2014, Aboriginal and Torres Strait Islander infants most commonly died from the International Classification of Diseases (ICD) ‘Certain conditions originating in the perinatal period’, including birth trauma, disorders relating to fetal growth, and complications from pregnancy, labour and delivery [5]. This accounted for around half of all Aboriginal and Torres Strait Islander infant deaths for 0

From 1998 to 2014, the IMR for Aboriginal and Torres Strait Islander infants 0-4 years has declined from 217 per 100,000 to 159 deaths per 100,000 [5]. This was a greater decline than for non-Indigenous children (from 115 per 100,000 to 73 deaths per 100,000) narrowing the gap from 102 per 100,000 to 86 per 100,000. Closing the gap would have been achieved if the deaths of 64 Aboriginal and Torres Strait Islander children had been prevented.

Causes of death

Cardiovascular disease was the leading cause of death of Aboriginal and Torres Strait Islander people in 2013, being responsible for 24% of the deaths of Aboriginal and Torres Strait Islander people living in NSW, Qld, WA, SA and the NT [6]. The next most common causes of death were: ICD ‘Neoplasms’ (mainly cancers) being responsible for 21% of deaths; followed by ICD ‘External causes’ (injury) (15%); ICD ‘Endocrine, nutritional and metabolic diseases’ (including diabetes) (9.1%); and ICD ‘Diseases of the respiratory system’ (8.2%).

In terms of specific conditions, coronary heart disease (CHD) (also known as ischaemic heart disease) was the leading cause of death of Aboriginal and Torres Strait Islander people living in NSW, Qld, WA, SA and the NT in 2015 at twice the rate of non-Indigenous people (Table 10) [7]. The other leading specific causes of death of Aboriginal and Torres Strait Islander people were diabetes (rate ratio: 4.7), chronic lower respiratory disease (rate ratio: 2.6) and lung and related cancers (rate ratio: 1.8).

Table 10. Numbers and rates of the leading causes of Aboriginal and Torres Strait Islander deaths and Indigenous:non-Indigenous rate ratios, NSW, Qld, WA, SA and the NT, 2015

Cause of death

Number

Rate

Rate ratio

Coronary heart disease

394

143

2.0

Diabetes

194

77

4.7

Chronic lower respiratory disease

175

72

2.6

Lung and related cancers

154

56

1.8

Suicide

152

26

2.0

Cirrhosis and other liver diseases

104

25

3.8

Cerebrovascular disease

91

45

1.1

Land transport accidents

84

15

2.9

Dementia

71

50

1.1

Diseases of the urinary system

68

29

2.5

Notes:

  1. See source for the ICD codes for the causes of death; excludes ‘symptoms, signs and ill-defined conditions’
  2. Rates are deaths per 100,000, standardised to the Australian 2001 ERP
  3. Rate ratio is the Indigenous rate divided by the non-Indigenous rate (not shown)

Source: ABS, 2016 [7]

The leading causes of death were different for Aboriginal and Torres Strait Islander and non-Indigenous people in NSW, Qld, WA, SA and the NT during 2015 [7]. While in both populations people died most commonly from CHD, the next leading causes of death for non-Indigenous people were dementia followed by cerebrovascular diseases. Diabetes and chronic lower respiratory disease - the other leading causes of death for Aboriginal and Torres Strait Islander people - were ranked lower for non-Indigenous people.

In 2015, the leading specific causes of death differed for Aboriginal and Torres Strait Islander males and females living in NSW, Qld, WA, SA and the NT [7]. While the first leading cause of death of both Aboriginal and Torres Strait Islander males and females was CHD, the next leading causes of death for males was suicide and diabetes. The next leading causes of death for Aboriginal and Torres Strait Islander females were diabetes and chronic lower respiratory disease.

Maternal mortality

Box 5: Maternal deaths

Maternal deaths refer to pregnancy-related deaths occurring to women during pregnancy or up to 42 days after delivery [8]. Direct maternal deaths refer to those resulting from obstetric complications (including in pregnancy, labour, and in the first few weeks after delivery) from interventions, omissions, and incorrect treatment. Indirect maternal deaths refer to those resulting from a previously existing disease, or a disease that developed during pregnancy, that were not a direct result of obstetrics but aggravated by pregnancy.

Maternal mortality ratios (MMRs) are calculated by dividing the number of maternal deaths (direct and indirect) by the number of women who gave birth to babies weighing at least 400 grams or who reached at least 20 weeks gestation; this result is then multiplied by 100,000.

In Australia in 2008-2012, eight of the 102 maternal deaths were of Aboriginal and Torres Strait Islander women (Indigenous status was not reported in 23 of the deaths) [8]. The leading contributors to causes of maternal death among Aboriginal and Torres Strait Islander women were cardiovascular conditions, sepsis, and psychosocial conditions.

Reflecting the higher rate of confinements, the MMR for Aboriginal and Torres Strait Islander women in 2008-2012 was 14 deaths per 100,000 confinements, around 2.1 times higher than the ratio of 6.6 per 100,000 for non-Indigenous women [8] (Table 11). For direct maternal deaths, the ratio of 6.9 per 100,000 for Aboriginal and Torres Strait Islander women was 2.2 times the ratio of 3.2 per 100,000 for non-Indigenous women (Derived from [8][9][10][11][12][13]).

Table 11. Numbers of women who gave birth and maternal deaths, and maternal mortality ratios, by Indigenous status, Australia, 2008-2012

Indigenous status

Women who gave birth

Maternal deaths

Maternal mortality ratio

Indigenous

57,979

 

 

Direct and indirect maternal deaths

  8

 

14

Direct maternal deaths

 

4

6.9

Non-Indigenous

1,428,131

   

Direct and indirect maternal deaths

 

94

6.6

Direct maternal deaths

 

45

3.2

Notes:

  1. Maternal mortality ratio is the number of maternal deaths divided by the number of women who gave birth (in 100,000s)
  2. Due to some uncertainty about the numbers of Indigenous deaths and confinements, some caution must be exercised in the interpretation of the ratios
  3. The non-Indigenous numbers and ratios include deaths for which Indigenous status was not known. This probably results in a slight, unknown overestimate of non-Indigenous numbers and ratios, and a resultant underestimate of the differences between Indigenous and non-Indigenous women

Source: Derived from Laws, Li, Sullivan, 2010 [9], Li, McNally, Hilder, Sullivan, 2011 [10], Li, Zeki, Hilder, Sullivan, 2012 [11], Zeki, Hilder, Sullivan, 2013 [12], Hilder, Zhichao, Parker, Jahan, Chambers, 2014 [13], Humphrey, Bonello, Chughtai, Macaldowie, Harris, Chambers, 2015 [8]

Avoidable mortality

Avoidable mortality refers to deaths that could have been prevented with timely and effective health care, including early detection and effective treatment, as well as appropriate modifications of lifestyle behaviours (such as quitting smoking) [14].

There were 7,079 deaths from avoidable causes among Aboriginal and Torres Strait Islander people aged 0-74 years living in NSW, Qld, WA, SA and the NT in the five-year period 2008-2012 [3]. Age-adjusted rates for avoidable deaths of Indigenous people were highest in the NT (789 per 100,000) and lowest in NSW (304 per 100,000) [15]. Aboriginal and Torres Strait Islander people died from avoidable causes at 3.0 times the rate of non-Indigenous people.

In 2008-2012, the most common conditions contributing to avoidable deaths among Aboriginal and Torres Strait Islander people aged 0-74 years living in NSW, Qld, WA, SA and the NT were CHD (19%), cancer (18%), diabetes (10%), and suicide (8.9%) [15]. The death rates from avoidable causes were 12.0 times higher for Indigenous people than for non-Indigenous people for diabetes, 3.8 times higher for CHD, 1.7 times higher for cancer and 2.0 times higher for suicide.

Between 1998 and 2012, after age-adjustment, there was a 27% decline in the death rate from avoidable causes for Aboriginal and Torres Strait Islander people aged 0-74 years living in NSW, Qld, WA, SA and the NT [15].

References

  1. Australian Bureau of Statistics (2016) Deaths, Australia, 2015. Retrieved 28 September 2016 from http://www.abs.gov.au/ausstats/abs@.nsf/mf/3302.0?OpenDocument
  2. Australian Bureau of Statistics (2013) Life tables for Aboriginal and Torres Strait Islander Australians, 2010-2012. Canberra: Australian Bureau of Statistics
  3. Australian Health Ministers' Advisory Council (2015) Aboriginal and Torres Strait Islander health performance framework 2014 report. Canberra: Department of the Prime Minister and Cabinet
  4. Australian Institute of Health and Welfare (2011) Principles on the use of direct age-standardisation in administrative data collections: for measuring the gap between Indigenous and non-Indigenous Australians. Canberra: Australian Institute of Health and Welfare
  5. Steering Committee for the Review of Government Service Provision (2016) Overcoming Indigenous disadvantage: key indicators 2016 report. Canberra: Productivity Commission
  6. Australian Bureau of Statistics (2015) Causes of death, Australia, 2013. Canberra: Australian Bureau of Statistics
  7. Australian Bureau of Statistics (2016) Causes of Death, Australia, 2015: Deaths of Aboriginal and Torres Strait Islander Australians. Retrieved 28 September 2016 from http://www.abs.gov.au/ausstats/abs@.nsf/Lookup/by%20Subject/3303.0~2015~Main%20Features~Summary%20of%20findings~1
  8. Humphrey MD, Bonello MR, Chughtai A, Macaldowie A, Harris K, Chambers GM (2015) Maternal deaths in Australia 2008-2012. Canberra: Australian Institute of Health and Welfare
  9. Laws PJ, Li Z, Sullivan EA (2010) Australia's mothers and babies 2008. Canberra: Australian Institute of Health and Welfare
  10. Li Z, McNally L, Hilder L, Sullivan EA (2011) Australia's mothers and babies 2009. Canberra: Australian Institute of Health and Welfare
  11. Li Z, Zeki R, Hilder L, Sullivan EA (2012) Australia's mothers and babies 2010. Canberra: Australian Institute of Health and Welfare
  12. Li Z, Zeki R, Hilder L, Sullivan EA (2013) Australia's mothers and babies 2011. Canberra: Australian Institute of Health and Welfare
  13. Hilder L, Zhichao Z, Parker M, Jahan S, Chambers GM (2014) Australia’s mothers and babies 2012. Canberra: Australian Institute of Health and Welfare
  14. Page A, Tobias M, Glover J, Wright C, Hetzel D, Fisher E (2006) Australian and New Zealand atlas of avoidable mortality. Adelaide: Public Health Information Development Unit, University of Adelaide
  15. Steering Committee for the Review of Government Service Provision (2014) Overcoming Indigenous disadvantage: key indicators 2014. Canberra: Productivity Commission

Footnotes

9. The median age at death is the age below which 50% of people die. Because the measure partly reflects the age structures of the respective populations, it is a less precise measure than age-specific death rates, which are summarised below.

 

Table of Contents

collapseCollapse
expand Expand
    Last updated: 3 March 2017
     
    Return to top
    spacing
    general box

    Contribute

    Share your information » Give us feedback » Sign our guestbook »
    spacing
    spacing